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Background: A serious medical condition linked to pulmonary hypertension (PH), right ventricular dysfunction (RVD), and cardiovascular consequences is coronavirus (Covid-19) infection. Objective: This study aimed to assess the relation between the rise of cardiac troponin at base line investigation of COVID patients and the development of pulmonary hypertension 3 months after recovery from the infection. Subjects and methods: The study was conducted as a cross-sectional descriptive study and included 104 non-critically ill patients 3 months after recovery from Covid-19 pneumonia. They were divided into 2 groups; mild cases and moderate/severe non-critically ill cases based on the WHO criteria at the time of admission. Troponin at the time of admission was measured. A full echocardiographic assessment of the right ventricle was done, and the pulmonary artery systolic pressure was calculated for every patient. Results: In COVID-19, PH is a common complication encountered after recovery, especially in moderate/severe (non-critically ill) cases. We observed increased incidence of PH in the moderate/severe group 3 months' post-recovery, significantly correlated with the initial levels of the cardiac troponin at admission (p < 0.001). Conclusions: There was a statistically significant positive correlation between troponin I levels at baseline admission and the development of pulmonary hypertension (r2 = 0.696, p = < 0.001) 3 months after recovery from the infection. [ABSTRACT FROM AUTHOR]

Background: COVID-19, triggered by the SARS-CoV-2 virus, was shown to have a profound effect on cardiac function. However, the long-term implications of myocardial damage in individuals who have recovered from the infection are not yet fully understood. Aim: This study aimed to identify the early changes in right ventricular (RV) function three months after recovery from COVID-19 using Speckle Tracking Echocardiography (STE) and Global Longitudinal Strain (GLS). Methods: This study was designed as a cross-sectional descriptive analysis and included 104 patients who had recovered from COVID-19 pneumonia during a three-month timeframe. The participants have been categorized into two groups based on the severity of their illness: mild cases and moderate/severe cases. Results: The demographic characteristics of the two groups broadly were similar with no statistically significant differences. The average age of the participants was 48.8 ± 10.7 years, with males representing 55.8% of the study population. The average body mass index (BMI) was 23.6 ± 0.71 kg/m². Furthermore, 45% of the participants had diabetes, and 34% were diagnosed with hypertension. Significant statistical differences were observed in right ventricular function parameters between the moderate/severe group and the mild group. The moderate/severe group showed a marked early reduction in both RV-GLS and RV-FWLS compared to the mild group. However, no early impairment was detected in right ventricular longitudinal function as measured by TAPSE. Conclusion: Speckle-tracking echocardiography proved to be a valuable tool for early detection of abnormalities that are not easily identified by conventional echocardiography, particularly in assessing strain on the right ventricle. [ABSTRACT FROM AUTHOR]

Importance: Rheumatic heart disease (RHD) remains a public health issue in low- and middle-income countries (LMICs). However, there are few large studies enrolling individuals from multiple endemic countries., Objective: To assess the risk and predictors of major patient-important clinical outcomes in patients with clinical RHD., Design, Setting, and Participants: Multicenter, hospital-based, prospective observational study including 138 sites in 24 RHD-endemic LMICs., Main Outcomes and Measures: The primary outcome was all-cause mortality. Secondary outcomes were cause-specific mortality, heart failure (HF) hospitalization, stroke, recurrent rheumatic fever, and infective endocarditis. This study analyzed event rates by World Bank country income groups and determined the predictors of mortality using multivariable Cox models., Results: Between August 2016 and May 2022, a total of 13 696 patients were enrolled. The mean age was 43.2 years and 72% were women. Data on vital status were available for 12 967 participants (94.7%) at the end of follow-up. Over a median duration of 3.2 years (41 478 patient-years), 1943 patients died (15% overall; 4.7% per patient-year). Most deaths were due to vascular causes (1312 [67.5%]), mainly HF or sudden cardiac death. The number of patients undergoing valve surgery (604 [4.4%]) and HF hospitalization (2% per year) was low. Strokes were infrequent (0.6% per year) and recurrent rheumatic fever was rare. Markers of severe valve disease, such as congestive HF (HR, 1.58 [95% CI, 1.50-1.87]; P < .001), pulmonary hypertension (HR, 1.52 [95% CI, 1.37-1.69]; P < .001), and atrial fibrillation (HR, 1.30 [95% CI, 1.15-1.46]; P < .001) were associated with increased mortality. Treatment with surgery (HR, 0.23 [95% CI, 0.12-0.44]; P < .001) or valvuloplasty (HR, 0.24 [95% CI, 0.06-0.95]; P = .042) were associated with lower mortality. Higher country income level was associated with lower mortality after adjustment for patient-level factors., Conclusions and Relevance: Mortality in RHD is high and is correlated with the severity of valve disease. Valve surgery and valvuloplasty were associated with substantially lower mortality. Study findings suggest a greater need to improve access to surgical and interventional care, in addition to the current approaches focused on antibiotic prophylaxis and anticoagulation.